Overview
On January 17, 2024, the Center for Medicare and Medicaid Services (CMS) announced the release of a long-expected rule, CMS-0057-F, the CMS Interoperability and Prior Authorization Final Rule (“the rule”). This rule contains a set of technical and operational mandates intended to support the ongoing move to value-based care and free flow of healthcare information. This document walks through key aspects of CMS-0057-F, including each type of information sharing, associated technical and operational requirements, timelines, and resulting opportunities for performance improvement. We trust it will be a resource shared across your organization to help understand, plan for, and capitalize on this important advancement toward value-based care.